Healthcare IT Services
CORE CLINICAL is a leader in healthcare IT and healthcare IT consulting. Our professionally trained information technology
and Healthcare Experts provide unparalleled service for your entire healthcare IT needs. From building your Website,
Developing HIS/ EMR systems to System Security, Database Services, Disaster Recovery etc, CORE CLINICAL strives to
provide the highest level of service, working with a sense of urgency and sensitivity for important medical information,
we offer strategic solutions that meet your healthcare IT needs.

Healthcare IT Consulting
CORE CLINICAL works as a consultant with your existing or on-site IT staff to ensure your network and infrastructure are working
properly and efficiently. With CORE CLINICAL, you not only receive IT backup but you also will get in-depth healthcare
IT consultation and guidance. Our professional IT staff and biomedical engineers help guide you through the process
of managing your network as well as other healthcare related services including EMR Implementation and EHR implementation.

Software Development
The Company founders have combined experience of 80+ years in IT and Healthcare services like Clinical Trials, Patient
Compliance Management, Disease Management, Patient Records Management, EMR, Medical Transcription, Hospital Management,
Software Development, Systems Analysis, Systems Administration, Network and Data Security, Web Application Development,
Remote Infrastructure Management etc.
Founders have solid experience of serving and satisfying the business needs of clients across the globe especially from
countries like USA, UK, Singapore, India, UAE, Europe etc. CCSPL team members are very well experienced in HIPAA and HL7.
With the solid foundation in Information Technology and Healthcare, we are able to offer full range of Software Services
to Healthcare providers like Hospitals, Clinics, GP, Radiology Centers, CRO, Clinical Trial Companies as well as Medical Equipment Manufacturers.
Team and skills
Our Team Members are qualified, experienced Doctors and IT Professionals
Subject Matter Experts
We have a team of highly qualified doctors who are being trained work in areas of Clinical Trials, Clinical Data Management,
Medical Records Management, Clinical Data Summarization, Clinical Project Management, Radiology, Imaging, Medicine, Surgeries,
EMR & HIS consulting.
Coming from the medical background, they are very well versed with identifying the information that would make an impact on the
future medical treatment of the patients when making a critical medical decision. Combined that with our extensive training, they
are the masters of the game.

We also have highly experienced Database Management Experts, Network Specialists and Software Programmers who create the required IT
services for these projects

Our application development services include requirement gathering/analysis, project planning, execution, and management, as well as
independent testing, deployment, and maintenance.

Healthcare Process Reengineering
CORE offers a full range of re-engineering services for legacy systems including platforms porting, language migration, and end-to-end
system redevelopment. Our re-engineering methods can provide migration from one environment to another, reverse engineering, or application
re-hosting. Expansion challenges are fully addressed while preserving long-established business practices that are built into the old system.
Our specialists have a profound knowledge of all types of operating systems and technologies, from those released in the
early-1980s up to the latest tools and programming languages.
• Version upgrade services
• Database migration
• Re-engineering
• Functionality upgrades
• Packaged applications customization
• Porting from one platform to the other

Maintenance & Support
We can perform any and all routine IT support functions in order to free up your existing IT resources to work
on more strategic IT objectives. In addition, innovative software development capabilities enable us to provide
knowledge transfer and professional support for legacy applications and systems.

Other Healthcare IT Services
CORE CLINICAL is revolutionizing the way healthcare information technology, clinical informatics are used together
to provide a single solution for the healthcare industry. CORE CLINICAL’s professionals are cross trained in all areas
of healthcare IT and biomedical engineering and set the standard for healthcare IT industry wide. CORE CLINICAL also offers
offsite data backup, server virtualization, and document scanning services to help streamline informatics in your facility.

About us

COMPANY PROFILE
Core Clinical Services (CCSPL) has been founded by the finest minds in the Information
Technology and Healthcare Industries. The founders have combined experience of 80+ years in
IT and Healthcare services like Clinical Trials, Patient Compliance Management, Disease Management, Patient
Records Management,, Clinical and Medical Data Summarization, EMR Implementation/ Customization, Hospital
Management, Software Development,Systems & Network Administration, Data Security, Web Application
Development, Remote Infrastructure Management etc.
Founders have solid experience of serving and satisfying the business needs
of clients across the globe especially from countries like USA , UK , India , UAE, Europe etc.
CCSPL team members are very well experienced in HIPAA and HL7.
We also have multilocational facilities for services like Software Development,
Technical Services and Customer Service for our clients.

CCSPL has been formed as a dedicated entity to serve Healthcare Industry across the globe and especially,
most niche areas in Healthcare and Clinical Research namely Clinical Data Management, Medical Records Summarization,
Medico Legal Services, Medical and Clinical Records Analysis,EMR Implementation & Customization, Teleradiology Services etc.

CCSPL has developed special skills for all these areas of services in the Healthcare & Clinical Management domains.
Our highly qualified and experienced teams makes sure that our clients are satisfied with the quality of work and also
in cost saving by providing a combination of onshore and offshore services.

TEAM
Our Human Capital is our biggest asset. This is where we have a cutting advantage over our competitors.
CORE Clinical Services has multiple teams of highly qualified and experienced doctors from all major
specializations in medical sciences. Our teams work in TWO or THREE shifts (if required) and hence can
help you to become "paperless" in a matter of few weeks rather than months and years.

Our Team Members are Highly Qualified, Experienced Doctors and IT Professionals
These are the fully qualified doctors who are being trained work in areas of Clinical Trials, Clinical Data Management,
Medical Records Management, Clinical Data Summarization.

Coming from the medical background, they are already very well versed with identifying which information would make an
impact on the future medical treatment of the patients as they know themselves what medical information they would
be looking for when making a critical medical decision. Combined that with our extensive training,
our team members are the masters of the game.

We also have highly experienced Database Management Experts, Network Specialists and Software Programmers
who create the required IT services for these projects.
Data Quality Managers
These are the highly qualified doctors who have vast experience in clinical data management and medical records management
etc. Hence, it would be these doctors who would be responsible for monitoring the quality of the data that goes into the
practice clinical systems. They would audit the batches of patient summaries generated to check the data quality and to
ensure that the defined criteria are met. Our quality control measures consist of very strict and stringent policies,
which our quality managers ensure are implemented and followed.

Four Phases of Clinical Studies in HumansPhase 1 Trials
Clinical trials are organized into four categories, called phases. Phase 1 trials are primarily concerned with assessing
the drug’s safety and tolerability and are the first step in testing new investigational medicines in humans.
The patients in these trials usually number 20-100 and the trials may last several months. In addition to studying the
investigational drug’s safety profile including the safe dosage range, these trials are designed to determine what happens to
the investigational drug in the human body and how the investigational drug is absorbed, distributed, metabolized, excreted, and its
duration of action. A Phase 1 trial will also investigate side effects that occur as dosage levels are increased. Except for drugs used
to treat cancer, Phase 1 clinical trials are usually conducted in normal, healthy individuals and are not intended to treat (or prevent)
disease or illness. Because cancer can be such a life-threatening condition, Phase 1 trials with anti-cancer drugs are usually carried
out in patients who already have the disease.

Phase 2 Trials
Once a drug has been shown to be safe, it must still be tested for efficacy; that is, whether or not the experimental medicine has
a desired effect on the targeted disease. Phase 2 trials are therapeutic studies to evaluate efficacy and to assess short-term safety
of the study drug in patients suffering from a disease or condition for which the study drug is intended. This phase also determines
appropriate dose ranges/regimens and, if possible, clarification of dose-response relationships to provide an optimal background for
the design of larger therapeutic trials. Phase 2 trials are usually randomized, meaning that patients receiving treatment are
divided between those that are administered the investigational drug, some that receive a comparable drug currently used to treat the targeted disease, and those that receive no drug (commonly referred to as placebo, an inactive substance that looks like the investigational drug). These trials are usually "blinded," a term used to describe that the researchers and patients are not aware of which group of patients is receiving the experimental drug and which group is not. The reason for "blinding the study" is to prevent bias from the researcher and patient when determining the effect experienced from the study medicines. In this manner, the trial can provide the investigators and the regulatory agency (e.g., FDA) comparative information about the relative safety of the new drug and its effectiveness. The number of patients in this phase of development typically ranges from 100 to 500 volunteer patients with disease. Typically, Phase 2 trials last from several months to up to 2 years .

Phase 3 Trials
Phase 3 trials, also referred to as registration or confirmatory trials, are designed to demonstrate efficacy and safety of the
investigational drug or line extension in a larger population of patients with the disease that the drug is intended to treat.
This requires large trials with patients who have the disease and involves comparing the investigational drug to comparator drugs
and/or placebo. These trials usually enroll between 1,000 and 5,000 patients, last for 3 years or longer, and are conducted in a
hospital or clinic setting. Physicians monitor the patients closely to confirm efficacy and identify adverse events from long-term use.
Phase 3 trials provide evidence on whether a drug “works,” what dose should be used, what the risks of the molecule are,
which patients may benefit from the therapy, and other information in determining whether the drug should be used in humans. Once Phase
3 trials are successfully completed, they are submitted to regulatory health agencies (e.g., FDA, European Medicines Agency [EMEA])
for review and possible marketing approval. Results of Phase 3 trials will determine the product
labeling/prescribing information and how physicians are instructed to use the drug.

Phase 4 Trials
Phase 4 clinical trials are often called "post-marketing" trials because they begin after the Phase 1, 2, and 3
trial results have been given to the regulatory agency for review and marketing approval. Phase 4 trials usually enroll
between several hundred to several thousand patients and may be designed to further evaluate safety in large populations;
to determine if the drug is effective against other disease states; to test different ways of taking the drug such as tablets,
time-release capsules, or syrups; and/or to determine the cost-effectiveness of the new drug relative to traditional other new therapies.
Phase 4 trials typically occur throughout the life cycle of the approved medicine and are often required as a condition of marketing approval.

Clinical Trials

Our CRO Services
Our experience is truly our most valuable asset, and will be what defines your success. As a CRO, we have built a breadth of
clinical research services to offer our Sponsors. In-house, full-time professionals provide all services but wherever necessary,
CCSPL takes the help of 3 rd parties who are competent and who sign the NDA/ HIPAA Agreements.

Recruitment Management
Our multi-center recruitment management division, Predictive Enrollment Partners, operates with a unique paradigm for patient recruitment,
which has evolved from our long experience in successful recruitment at CCSPL's clinical sites. Our skilled, critical examination of a
protocol leads to our backbone and cornerstone, a clinically grounded approach to patient recruitment. Predictable enrollment of clinical
trials is the result of a complex, interrelated process of six proven steps:

By effectively partnering with each site's personnel, our on-going, intense tracking of a variety of productivity rates clearly
and definitively allows us to direct change in recruitment management strategies. We pride ourselves in our ability to take advantage
of early signs of change in order to make real-time, impactful, cost-saving decisions.

Clinical Trials

Clinical Monitoring
CCSPL functions with a regionally based monitoring system. Our CRAs are required to have two or more years of field monitoring experience.
We have a QC monitor evaluation process to supplement individual monitor training, in order to maintain the highest quality standards.

CRAs are required to be certified in all regulatory guidelines:
• GCP
• CFR
• ICH

1. CRF Annotation
2. Preparing GUI for the CRF pages. This can be done both as standalone application and RDC (Remote Data Capture) depending on the
client specification and budget.
3. Preparing application to pull data from the GUI and place in the respective field of the tables in the database.
4. Design the tables and schema in the database.
5. Validate the database
6. Run scripts and test the database.
7. Prepare integrated application to import data directly from the labs into the database to avoid manual errors while loading the data.
8. Prepare backup strategies for the database.
9. Help client in data upload if PDF’s of CRF are sent (offshore activity to save on budget).
10. Keep track of Adverse Events and Serious Adverse Events (if demanded prepare a different database for AE and SAE as per FDA norms).
11. Automatic generation of DCF to the site in case of data discrepancy.
12. Analyze and audit the database at frequent intervals (Quality control and assurance methodologies used).
13. Generate queries needed by the client for data analysis by Statisticians.
14. Give offshore services to the client in order to save money.

All these services of CDM are given end to end or in part as required by the client.
We try to give majority of the activities off shore so that the client can save money. If needed onshore support can also be provided.
Along with the CDM activities we have a dedicated team of Doctors, Pharmacists and other people to provide actual research Execution,
Monitoring and project Management activities for conduction of Phase II, III and IV trials in India and abroad.

Most of the Board Members being into the medical field for the last 20- 25 years have their medico network in the majority hospitals
of Pune and a 200-mile radius, which has population strength of 8 million in the city and around 25 million in the radius of 200 kms.
Pune is the Oxford of the East and trained and qualified resources are available in abundance.
Patient recruitment for the Clinical Trials is much faster in Pune and highly qualified Investigators are available to conduct the trials
efficiently and ethically.

• Investigator Site Audits for Conformance with Good Clinical Practices (GCPs), local government Guidance and regulations

• SOP and Regulatory Compliance

• Vendor Inspections

Clinical Project Management

Clinical Trial Site And Project Management activities
for Sites include but are not limited to following activities:
• Site Identification
• Site selection
• Site inspection
• Investigator identification and selection
• Resource Management
• Site monitoring
• Patient recruitment and follow-up
• Drug management – end to end
• Data management
• Documentation
• Regulatory affairs compliance
• IRB coordination
• Site closure
End to End Project Management can be done with expert people already working in this field. Some of the experienced staff
of Core Clinical’s are already in place; working on different aspects of health care field. Dr. Sanjog is at present
working with 20 people in the Implementation of Health Information System & PACS for the Ministry of Health UAE.

Position of SMO within the clinical trial process

We act as a bridge between medical institution and pharmaceutical companies at the front lines of clinical development .
This will make a large contribution to the smooth implementation of clinical trial from site selection to preparation of
clinical study report.

Global Need of Patient Medication Compliance and Disease Management
In medicine, compliance (also termed as adherence) describes the degree to which a patient correctly follows medical advice.
Most commonly, it refers to medication or drug compliance, but may also mean use of medical appliances such as compression
stockings, chronic wound care, self-directed physiotherapy exercises, or attending counseling or other courses of therapy.
Both the patient and the health-care provider affect compliance, and a positive physician-patient relationship is the most
important factor in improving compliance, although the high cost of prescription medication also plays a major role.Medication non-compliance in patients is a major medical problem in across the globe.
It is crucial that we improve our understanding of the issue because at the very least, costs as a result of patient
noncompliance are estimated at billions of dollars per year and are the result of adverse outcomes such as hospitalization,
development of complications, disease progression, premature disability, or death.

The following is a list of typical compliance statistics:

Millions of people with treatable ailments die each year because they do not take their medication properly.

Approximately 25 % to 35 % of patients never fill their original prescriptions given by doctors. It means they don’t take medicines at all.

Approximately 50 % to 70 % people do not continue the medicines or do not refill their prescriptions.

50 % to 60 % people forget to take their medication doses.

Most patients forget Physician Appointments and Regular Check ups.

Over 70 % percent of all patients cannot identify their own medications.

Approximately 40 % to 50% of all patients ignore or otherwise compromise instructions concerning
their medication.

Hospitalization costs due to patient noncompliance are in many billions of dollars.

Noncompliance is typically cited as occurring in from 50% to 75% of patients.

In other words 50% to 70% of patients do not properly take prescribed medication. The rate of noncompliance is even higher

in patients with chronic illnesses. This is because the drug regimens for these patients are often long-term, complex regimens
that alter existing behavioral patterns. Clearly, the research has proven that noncompliance is a serious medical issue. It is a
major medical problem that may lead to death and elevated costs, both for patients and providers.

Examples of the rate and consequences of non-compliance for selected medical disorders is as follows:

Diabetes non-compliance (98% in US) is the principal cause of complications related to diabetes including nerve damage and kidney failure

Hypertension non-compliance (93% in US, 70% in UK) is the main cause of uncontrolled hypertension-associated heart attack and stroke

With our solid experience in healthcare and excellent technical capabilities, we have developed fully automated tools for patients,
doctors, hospitals and patient care takers to increase patient compliance and hence help them avoid health complications.
We provide easy to access software tools and portable devices to patients which would act as angels for them and monitor
their medication compliance and test compliances for various home bases or clinic based checks like monitoring Blood Glucose
Levels, Blood Pressure, Weight, Pulse etc.

Some of our tools would help the patients by providing reminders for

Taking Medication on time

Filling Prescription/ Buying Medicines

Conduct Home Health Tests

Doctor’s appointments

Regular Health Checkups etc.

Health Monitor ®is a medication and health-monitoring device that is being designed to measure
medication/ health compliance levels of patients.
Patients tend to forget to take their medication prescribed by their physician and the forgetfulness increases
chances of the patient’s life being at risk, especially for patients with Diabetes, Hypertension, Asthma, CHD & similar chronic disease conditions.We have developed Health Monitor ® for the benefits of patients, doctors, caretakers etc.
The objective is to

Allow patients to maintain their electronic diary of medication & communicate the compliance to doctors without manual intervention

Remind them regularly to take prescribed medication

Remind them to take BP/ BG and Weight

Allow doctors to analyze compliance levels, improvements in the results and take further actions according to the results of compliance.

Make data of each patient available (online & real time) using web interfaces for Doctors, Patients, and Caretakers etc.

Clinical Data Management 1

• CRF Annotation
• Preparing GUI for the CRF pages. This can be done both as standalone application and RDC (Remote Data
Capture) depending on the client specification and budget.
• Preparing application to pull data from the GUI and place in the respective field of the tables in the database.
• Design the tables and schema in the database.
• Validate the database
• Run scripts and test the database.
• Prepare integrated application to import data directly from the labs into the database to avoid manual errors
while loading the data.
• Prepare backup strategies for the database.
• Help client in data upload if PDF’s of CRF are sent (offshore activity to save on budget).
• Keep track of Adverse Events and Serious Adverse Events (if demanded prepare a different database for
AE and SAE as per FDA norms).
• Automatic generation of DCF to the site in case of data discrepancy.
• Analyze and audit the database at frequent intervals (Quality control and assurance methodologies used).
• Generate queries needed by the client for data analysis by Statisticians.
• Give offshore services to the client in order to save money.

All these services of CDM are given end to end or in part as required by the client.
We try to give majority of the activities off shore so that the client can save money. If needed onshore support can also be provided.

Along with the CDM activities we have a dedicated team of Doctors, Pharmacists and other people to provide actual research Execution,
Monitoring and project Management activities for conduction of Phase II, III and IV trials in India and abroad.

All these services of CDM are given end to end or in part as required by the client.

We try to give majority of the activities off shore so that the client can save money. If needed onshore support can also be provided.

Most of the Board Members being into the medical field for the last 20- 25 years have their medico network in the majority hospitals
of Pune and a 200-mile radius, which has population strength of 8 million in the city and around 25 million in the radius of 200 kms.
Pune is the Oxford of the East and trained and qualified resources are available in abundance.

Patient recruitment for the Clinical Trials is much faster in Pune and highly qualified Investigators are available to conduct the
trials efficiently and ethically.

Clinical Data Management 2

CORE CLINICAL SERVICES was found on premise providing Healthcare provider with high quality, accurate and precise
information & data management.

Clinical Data Management is broken into very specific key tasks and all of them need to be managed by a Lead Data Manager.
This individual will be the single point of contact for all your Clinical Data Management needs.
We have defined metrics and turnaround times for each step of our processes from database build and entry to query resolution and QC.
This allows us to efficiently manage our time and ensure we provide you with accurate costs at the beginning of any study, which
minimizes change orders during the study.
We have a standard set of reports available that will detail each aspect of the data processing. These can be sent as regularly as
required to allow productive meetings, especially towards database lock.
Our dedicated CRF design team use latest tools and methods to create Case Report Forms, Source documentation, Diaries and Urinalysis
booklets. Each CRF is based on our RPL standard library of CRF modules . However our team will
modify or create CRFs in accordance with your needs to ensure you receive the module you specifically require.
CRF instructions are prepared alongside the design of the CRF to ensure site staffs are very clear on how to complete the required
pages. These can be incorporated into the document itself or be a standalone document.

CORE CLINICAL Services offers CDM services with maximum flexibility. Sponsors may contract all or a portion of their CDM work load
to CORE. Our infrastructure and clearly defined system interfaces provide us the flexibility to define work processes between a
sponsor system and our environment as well as seamless integration in to sponsor defined processes. Our systems & services are
based on industry recognized standards and technology platforms to ensure that even the most challenging data management
activities are efficiently and effectively addressed.

Health Care Informatics

Modern medical centers depend on computers and networked communications for functionality and to ensure quality
patient care. Specialists in healthcare IT are key contributors to health care facilities and health data management.
Interpreting medical information correctly can identify IT errors and solve problems quickly and efficiently.
Cross-trained IT/Clinical experts examine medical data properly. They understand medical language and terminology and can ensure that your
facility is functioning proficiently and without error.

Health Care Informatics Services

Our professional healthcare IT technicians help manage the technology change while keeping the basics of your
operation/facility in mind. We can not only manage your information systems, but we can also train your existing staff to work
on internal issues as well as serve as backup consultants for future biomedical and IT maintenance and problem solving.

Whether its technology relating to procuring/purchasing newer clinical devices or modalities, we can help in multiple areas:
• Implementation and clinical acceptance
• Recommend and implement computer networks, communication and IT upgrades
• Clinical technology evaluation

Backup Services

CORE offers offsite data backup and storage to ensure that your data is protected.
By using the CORE state-of-the-art back up system, you can ensure that your patient information is always recoverable
and kept safe.
Information is continually backed up to our servers in Nebraska. Our offsite servers are protected, always safeguarding your information.
If your servers ever fail or are destroyed we can send you your information on an external hard drive within one day’s time. At CORE, we
always work to keep your information protected and keep your facility running.
CORE provides full data backup daily. Once your initial data backup is completed, only the changed files are backed up to ensure
that information is accessible the next day. Some companies work with large databases, and back these up to tape locally. Often this
process takes so long, that it cannot be completed nightly, and must wait until the weekend. If you are working with large files,
CORE’s backup system will update only the portions that have been changed, ensuring your backups are completed on schedule.

Secure Data Backup
Backing up your data is key to ensuring that your information is always accessible and never lost. Keeping that data secure is just
as important. CORE will secure your data so that your company has piece of mind in knowing that your data is protected at the highest
level possible. CORE uses only encrypted transmission protocols to transfer your information to our servers. Once the data is on our
servers, you will be the only person authorized to access it.

Statistical Analysis

CORE’s statisticians are involved in all aspects of a data management project from protocol and CRF design
to statistical reporting. CORE’s statisticians have academic backgrounds with vast industry
experience in all phases of clinical trials across numerous therapeutic areas.
Pharmacokinetics, bioequivalence and Thorough QT, (TQT), are areas of specialized skill and expertise for CORE’s statisticians.
We operate a peer-review by dual independent programming of critical endpoint analysis, and all output is subjected to quality assurance review.

Methodology
CORE Clinical Services is engaged with many of the Healthcare organizations, Hospitals, Clinics, Law Firms,
Healthcare companies in USA and UK on the Clinical Data Management and Clinical Data Summarization Projects.

What is Medical /Clinical Data Summarization?
Data Summarization is a process whereby specific salient and significant aspects of patient's medical history are
extracted from their past medical notes/records to form a precise, succinct document. This provides a safe platform
of patient information, which provides comprehensive medical information about a patient to the appropriate and
precise use of read codes, medical and insurance forms, hospital consultations, operations details and more. The
patient summary would store patients' essential details such as their address, date of birth, Unique Medical Record
Number and their comprehensive health and medical care history, which includes the codes of the items along with
all significant aspects of a person's care such as: -

Why Create Electronic Patient Records?
Patients are likely to be treated by a variety of health care professionals in a range of locations throughout their lifetime.
Each doctor will keep a separate medical record focusing on the most recent encounter with the patient. Currently, these pieces
of vital medical information cannot be shared easily amongst different hospitals, clinics, GP surgeries or Social Caretakers
nationwide as the computers/networks in different buildings are not inter-connected and hence cannot communicate with each other.

Core Clinical Services is working on this crucial project to integrate the records & databases millions of patients in UK and USA.

Before undertaking the project, CORE Clinical Services would identify the client requirements and would conduct
requirement analysis and process analysis of the client’s processes and of any coding systems being used in
the surgery/ hospital etc. We would then setup a guideline document or a protocol for creating EMR/ EPRs, which
would dictate which information goes into the patient summaries.

• Our partner company/ principal/ vendor would scan the complete patient record; including front and back of all the
documents in-patient medical record file(s) with both sides of the file covers and blank sheets.

• Wherever required, a full audit history for every record summarized for further analysis at any stage is done. For
this reason, all medical records would be color coded to distinguish between records, which are:
1. Fully summarized.
2. Currently being summarized.
3. Waiting summarization.

• Team would set a cut-off date, after consulting with the surgery, to ensure that any new data
for existing or new
patients after that date needs to be recorded electronically.

STEP 2:
Scanned Images being summarized by our expert Doctors• This is most important stage of the project where
our highly experienced and trained team of doctors goes through
the all scanned images of each and every page in the patient medical record manually and then summaries those
sheets.

• Access to these files is given mostly using a highly secured Citrix Environment with access controlled using
dynamically generated pass-codes.
• The appropriate and frequent use of read codes will be adhered to when creating patient summaries.

STEP 3:
Integrating the final Summaries into the Clinical Data System

• This is that last step where all the data summaries created and audited by us are integrated into client’s practice
computer system with appropriate Medical CODES and disease registries. We would be using HL7 protocols and
templates for uploading these data summaries.

• Once summarized, the data quality will have to be assessed and approved before integrated into the summary
screen of your clinic's Health Information Management System. This is to ensure that the patient summaries meet the
defined quality criteria of the protocol set by us.

• All the scanned images of the patient records would be given to the surgery, which could use them as a backup for
the patients' paper records. This would not only save them space and money in maintenance but would also save a
lot of secretarial and administrative time when operating in a total "paperless" working environment.

Major Utilization of summarized medical records
The process of summarization of the patient records to provide all case details for the person who is reviewing the patient records.
The service takes its input from the patient's historical medical records and creates a patient information summary.
These records are generated by different care delivery organizations, over a long period of time, and collected into
back-end digital archives. Patient records cover multiple treatments for multiple conditions over the patient's lifetime.

• There are various users/ uses of the summarized data:
o Since summaries prepared by CORE's doctors are precise, accurate and concise, the phycisians treating
the patients with past history can quickly understanding the patients entire medical history
just by reading 1 or 2 pages instead of 100s of source pages.
o Clinical Systems can take these summaries as inputs and create patient records avoiding the need to lengthy, time consuming
and expensive data entry.
o EMR Systems can take the medically coded summaries by convering them to XML documents and HL7 messages.
o Pharma companies for statistical analysis.
o Physicians at the providers’ office - Specializing in Workmen Comp, Needs a summary to be submitted with the
Medical Records of the patient.
o In a medico Legal cases, The counsel to review the case, present them to Jury/Judge/Arbitrator

• Medical summary is performed in the following ways:
o Broad focus Medical Summary -assessing only nature and type of injury in the given set of conditions.
o Medical focus Summary - to assess whether the patient had been provided with the minimal standards of care
as per US based guidelines of health practices.
o This is followed by recommendations for obtaining the records unavailable for review, medical and medico-legal
findings suggesting nature of injury, research literature application equivocal with the pertinent issues found like
medical malpractice, personal injury and medical negligence.

Finally a conclusion is drafted suggesting the most evident cause of patient's injury based on the review of medical records and medical literature including guidelines pertinent to a particular health condition.

Approaches for Medical Summarization / Clinical Data Management
• The service will address the challenges by offering multiple views to the data.

• Gathering information pertaining to a specific specialist or field. This view may be implemented by dynamically
observing the usage of the deployed system by medical personnel and generalizing common user actions. This view
utilizes machine learning techniques for understanding caregiver behavior and for data analysis.

• Chronological summary of the medical treatment.

• Review of any prior injuries or pre-existing medical conditions.

• Explanation and definition of medical terminology and treatment.

• Outline of future treatment and/or related impairment.

• Commentary on the causal relationship of diagnoses and/ or treatment to the loss.

Methodology
CORE Clinical Services is engaged with many of the Healthcare organizations, Hospitals, Clinics, Law Firms,
Healthcare companies in USA and UK on the Clinical Data Management and Clinical Data Summarization Projects.

What is Medical /Clinical Data Summarization?
Data Summarization is a process whereby specific salient and significant aspects of patient's medical history are
extracted from their past medical notes/records to form a precise, succinct document. This provides a safe platform
of patient information, which provides comprehensive medical information about a patient to the appropriate and
precise use of read codes, medical and insurance forms, hospital consultations, operations details and more. The
patient summary would store patients' essential details such as their address, date of birth, Unique Medical Record
Number and their comprehensive health and medical care history, which includes the codes of the items along with
all significant aspects of a person's care such as: -

Why Create Electronic Patient Records?
Patients are likely to be treated by a variety of health care professionals in a range of locations throughout their lifetime.
Each doctor will keep a separate medical record focusing on the most recent encounter with the patient. Currently, these pieces
of vital medical information cannot be shared easily amongst different hospitals, clinics, GP surgeries or Social Caretakers
nationwide as the computers/networks in different buildings are not inter-connected and hence cannot communicate with each other.

Core Clinical Services is working on this crucial project to integrate the records & databases millions of patients in UK and USA.

Before undertaking the project, CORE Clinical Services would identify the client requirements and would conduct
requirement analysis and process analysis of the client’s processes and of any coding systems being used in
the surgery/ hospital etc. We would then setup a guideline document or a protocol for creating EMR/ EPRs, which
would dictate which information goes into the patient summaries.

• Our partner company/ principal/ vendor would scan the complete patient record; including front and back of all the
documents in-patient medical record file(s) with both sides of the file covers and blank sheets.

• Wherever required, a full audit history for every record summarized for further analysis at any stage is done. For
this reason, all medical records would be color coded to distinguish between records, which are:
1. Fully summarized.
2. Currently being summarized.
3. Waiting summarization.

• Team would set a cut-off date, after consulting with the surgery, to ensure that any new data
for existing or new
patients after that date needs to be recorded electronically.

STEP 2:
Scanned Images being summarized by our expert Doctors• This is most important stage of the project where
our highly experienced and trained team of doctors goes through
the all scanned images of each and every page in the patient medical record manually and then summaries those
sheets.

• Access to these files is given mostly using a highly secured Citrix Environment with access controlled using
dynamically generated pass-codes.

• The appropriate and frequent use of read codes will be adhered to when creating patient summaries.

STEP 3:
Integrating the final Summaries into the Clinical Data System

• This is that last step where all the data summaries created and audited by us are integrated into client’s practice
computer system with appropriate Medical CODES and disease registries. We would be using HL7 protocols and
templates for uploading these data summaries.

• Once summarized, the data quality will have to be assessed and approved before integrated into the summary
screen of your clinic's Health Information Management System. This is to ensure that the patient summaries meet the
defined quality criteria of the protocol set by us.

• All the scanned images of the patient records would be given to the surgery, which could use them as a backup for
the patients' paper records. This would not only save them space and money in maintenance but would also save a
lot of secretarial and administrative time when operating in a total "paperless" working environment.

Major Utilization of summarized medical records
The process of summarization of the patient records to provide all case details for the person who is reviewing the patient records. The service takes its input from the patient's historical medical records and creates a patient information summary. These records are generated by different care delivery organizations, over a long period of time, and collected into back-end digital archives. Patient records cover multiple treatments for multiple conditions over the patient's lifetime.

• There are two distinct users:
o Physicians at the providers’ office - Specializing in Workmen Comp, Needs a summary to be submitted with
the Medical Records of the patient.
o In a medico Legal cases, The counsel to review the case, present them to Jury/Judge/Arbitrator

• Medical summary is performed in the following ways:
o Broad focus Medical Summary -assessing only nature and type of injury in the given set of conditions.
o Medical focus Summary - to assess whether the patient had been provided with the minimal standards of care
as per US based guidelines of health practices.

o This is followed by recommendations for obtaining the records unavailable for review, medical and medico-legal
findings suggesting nature of injury, research literature application equivocal with the pertinent issues found like
medical malpractice, personal injury and medical negligence.

Finally a conclusion is drafted suggesting the most evident cause of patient's injury based on the review of medical records and medical literature including guidelines pertinent to a particular health condition.

Approaches for Medical Summarization / Clinical Data Management
• The service will address the challenges by offering multiple views to the data.

• Gathering information pertaining to a specific specialist or field. This view may be implemented by dynamically
observing the usage of the deployed system by medical personnel and generalizing common user actions. This view
utilizes machine learning techniques for understanding caregiver behavior and for data analysis.

• Chronological summary of the medical treatment.

• Review of any prior injuries or pre-existing medical conditions.

• Explanation and definition of medical terminology and treatment.

• Outline of future treatment and/or related impairment.

• Commentary on the causal relationship of diagnoses and/ or treatment to the loss.

• Our partner company/ principal/ vendor would scan the complete patient record; including front and back of all the
documents in-patient medical record file(s) with both sides of the file covers and blank sheets.

• Wherever required, a full audit history for every record summarized for further analysis at any stage is done. For
this reason, all medical records would be color coded to distinguish between records, which are:
1. Fully summarized.
2. Currently being summarized.
3. Waiting summarization.

• Team would set a cut-off date, after consulting with the surgery, to ensure that any new data
for existing or new
patients after that date needs to be recorded electronically.

STEP 2:
Scanned Images being summarized by our expert Doctors• This is most important stage of the project where
our highly experienced and trained team of doctors goes through
the all scanned images of each and every page in the patient medical record manually and then summaries those
sheets.

• Access to these files is given mostly using a highly secured Citrix Environment with access controlled using
dynamically generated pass-codes.

• The appropriate and frequent use of read codes will be adhered to when creating patient summaries.

STEP 3:
Integrating the final Summaries into the Clinical Data System

• This is that last step where all the data summaries created and audited by us are integrated into client’s practice
computer system with appropriate Medical CODES and disease registries. We would be using HL7 protocols and
templates for uploading these data summaries.

• Once summarized, the data quality will have to be assessed and approved before integrated into the summary
screen of your clinic's Health Information Management System. This is to ensure that the patient summaries meet the
defined quality criteria of the protocol set by us.

• All the scanned images of the patient records would be given to the surgery, which could use them as a backup for
the patients' paper records. This would not only save them space and money in maintenance but would also save a
lot of secretarial and administrative time when operating in a total "paperless" working environment.

Clinical Data Summarization

Major Utilization of summarized medical records
The process of summarization of the patient records to provide all case details for the person who is reviewing the patient records. The service takes its input from the patient's historical medical records and creates a patient information summary. These records are generated by different care delivery organizations, over a long period of time, and collected into back-end digital archives. Patient records cover multiple treatments for multiple conditions over the patient's lifetime.

• There are two distinct users:
o Physicians at the providers’ office - Specializing in Workmen Comp, Needs a summary to be submitted with
the Medical Records of the patient.
o In a medico Legal cases, The counsel to review the case, present them to Jury/Judge/Arbitrator

• Medical summary is performed in the following ways:
o Broad focus Medical Summary -assessing only nature and type of injury in the given set of conditions.
o Medical focus Summary - to assess whether the patient had been provided with the minimal standards of care
as per US based guidelines of health practices.

o This is followed by recommendations for obtaining the records unavailable for review, medical and medico-legal
findings suggesting nature of injury, research literature application equivocal with the pertinent issues found like
medical malpractice, personal injury and medical negligence.

Finally a conclusion is drafted suggesting the most evident cause of patient's injury based on the review of medical records and medical literature including guidelines pertinent to a particular health condition.

Clinical Data Summarization

Approaches for Medical Summarization / Clinical Data Management
• The service will address the challenges by offering multiple views to the data.

• Gathering information pertaining to a specific specialist or field. This view may be implemented by dynamically
observing the usage of the deployed system by medical personnel and generalizing common user actions. This view
utilizes machine learning techniques for understanding caregiver behavior and for data analysis.

• Chronological summary of the medical treatment.

• Review of any prior injuries or pre-existing medical conditions.

• Explanation and definition of medical terminology and treatment.

• Outline of future treatment and/or related impairment.

• Commentary on the causal relationship of diagnoses and/ or treatment to the loss.

• Qualified Doctors from the different arenas of the medical expertise.

• In built research database of Multiple Medical Conditions, READ CODES

• Efficient software solutions tailored to meet the needs of our clients in electronic record retrieval and management.

• High Quality tools to offer our services to comply with the standards in the industry

HIS / EMR Customisation & Implementation

HIS & EMR implementation

CORE CLINICAL SERVICES has a team of experts who are experienced Doctors, IT Experts and domain specialists.
We offer HIS implementation services for HIS/ EMR systems from variety of vendors.
Our team of experts will guide you right from the process selecting a right system, negotiations, vendor selection,
infrastructure creation, consulting, customization, implementation, training and support.

1. Pre Implementation
Services which can be provided by CORE Clinical
Pre Implementation Consulting in
a) Enterprise Architecture
b) Process Mapping and suggestions on Process reengineering.
c) ‘AS IS’ Workflow Design and suggestions on Workflow redesigning.
d) Formulate needs of the client.
e) Help in preparing the RFP
f) Help the Client in accessing the RFI’s and advise on product selection.
g) Suggest the Client on ways of automating the whole hospital.
h) Study and define the interfacing of the equipments with the HIS, EMR or EHR Systems.
i) Identifying the time line needed to do a proper implementation.

Electronic Medical Records (EMR)
Electronic medical records are the legal documents created by the healthcare facility,
which records what happened during a patients’ visit to that facility. Without proper
implementation of EMR systems, electronic health record systems cannot properly be created or implemented.
Properly integrated EMR systems will help reduce the opportunity for medical record error.

Electronic Medical Records (EMR) are the industry standard in medical records management.
CORE implements your EMR system with automated backups and creates a simple and easy-to-use electronic
medical record for your medical facility, imaging center, or hospital that allows for a smooth transition
when coordinated by our expert implementation team. CORE’s expertise in biomedical, clinical technology
informatics enables us to maintain a comprehensive medical records system for your organization at a practical cost.

From Administration…
CORE’s customization of a hosted EMR allows for your patients’ record to begin with their first appointment in a way
that fits your facility. Administrative staff can create the individual’s EMR upon their first scheduled visit and begin an
easily accessible record that tracks your patients all the way from administration to billings. And, with training and support
from CORE we can assure that all staff will understand how to use the system properly allowing for paperless and secure storage
for patient records.To Medical Professionals…
Doctors, nurses and nurse practitioners can access patient records easily and quickly, adding to patient notes and dictating directly
into the EMR. CORE’s EMR management provides doctors with more time to see patients and less time charting.To Billing…
The EMR managed by CORE is even capable of billing electronically. Your administrative staff can pull up
a patient’s bills at the front desk and your billing department can easily see the patient record to provide prompt billing statements. Even to Data Backup & Hosting…
With CORE managing your EMR you don’t have to worry about misplacing files or crashed hard drives. We back up your
data hourly to our secure off-site data storage center.
The best part is the whole system is paperless. You won’t have to worry about someone pulling the wrong file or misplacing it.
Access any patient information quickly 24 hours a day.

General EMR Workflow

Why Core Clinical Services ?

a) Highly experienced staff in HIS, EMR implementation
b) Client can save upto 40% of the costing on Project Management.
c) Client can utilize their staff for routine work and does not need to compromise on daily affairs
d) Client can get a sustained Support post implementation (both offshore and onsite)
e) Client saves valuable time as experienced staff oversees the implementation.

Implementation Methodology of Core Clinical Service for Electronic Medical Record Implementation:

Planning

Execution

Monitoring

Trainning

Closure

Medical Records Management

A medical record, health record, or medical chart is a systematic
documentation of a patient's medical history and care.
A good medical records management process & system could mean the difference between life and death for some individuals.

We see all kinds of medical records come into our office or even at client office, from the meticulously organized to
the totally unorganized.

We help you organize the medical records by using the following process:

We obtain hospital/ clinical chart (record) dividers from the supplier. The most economical
dividers are made of heavy paper with plastic coated tabs that mark the various sections of the chart.

Our record managers start at the top of the stack and place the pages into piles that correspond with each divider.
Once each paper is sorted into the right category, each section is organized in chronological order, starting with
the first day of the admission and so on. (When charts come from photocopy services they are often in reverse order,
with the end of the hospitalization at the top of the stack.)

Once the medical record is organized, we number the pages in the lower left or right corner.

Then the medical records are taken to a copying service and the records are duplicated on predrilled paper
(paper with 2 holes in it). We advise to at least two copies be made. The client is then advised to set aside the
record supplied by the hospital and keep it in a safe place.

We then place the duplicated copies of the record in three ring binders organized with the hospital chart
dividers.

Then we identify one of the two copies that have been made as the "working copy". This copy can
be flagged, underlined, highlighted and written on. The second copy will be used for expert witness review if the
case proceeds further. Since your set of records and the expert's will be identical, it will be easy to discuss the
case and refer to specific page numbers.

Medical Records Management System

A medical record, health record, or medical chart is a systematic documentation of a patient's medical history and
care. Our Electronic Medical Records Management System site is an effort our IT & healthcare specialists to build
an online health records for the doctors, hospitals, clinics. The ease of use of the service was the main goal of our
website so the doctors can add, edit, or delete their records with few clicks in few seconds. The On-Line service helps
the doctors to reach their records from anywhere at anytime with the total confidentiality of the records and the data. All
records are confidential hence we do not ask for the doctors names or their personal identities, instead our system will
treat each record as a unique identity of itself.

The system offers you graphical representations for your medications against lab test results for your patients
which gives you a first look understanding of the progress of every patient's health.

The system offers you the ability to generate medical reports for your patients and manipulate them with a minimal
number of clicks.

The system offers you the ability to share your patients reports with your patients (if you wish), so that they
can follow-up there cases at any time from any where.

As the system is Internet based, then you can access your patients' data any time from any where.

Medical Equipment Integration

Medical Equipment Integration Services
CORE Clinical Services is a global solutions and services provider to the healthcare and medical industry.
What helps us do this are our innovative software services, deep health industry expertise and cost effective solutions
designed for managing client’s business needs.
Infusion pumps, ventilators, and bedside monitoring systems stand-alone devices are essential part of any healthcare
/ medical facility. Most of the present systems are isolated and do not facilitate acquisition of data from these devices
to be integrated and imported into Health Information System (HIS) or Electronic Medical Records System (EMR).
There is a great need of such equipment being integrated with HIS/ EMR/ Clinical Software allowing vital signs data to be
collected directly from devices like ECG monitors and distributed to a patient's electronic medical record (EMR), or data
sets for medication dosages, which can be uploaded directly into infusion pumps. All of which is aimed at reducing the
possibility of error.

CORE has a team of experts in Biomed, Clinical Technologies and Software who design software and interfaces
required for integrating medical devices of various equipment companies with computers.

What we do ?

Interface any Model or Make of clinical, pathological, radiology, cardiology, ICU Equipment,
Ventilators Anesthesia machines and all other testing equipment with PC and allow integrating
them with the HIS / EMR system for flawless and accurate data exchange.

Design components that can integrate with any existing software/system

Develop new interfaces as per your requirements using latest technologies and tools

Create easy and fast equipment configuration and settings

They would be very user friendly access with minimum training

Wide range of reporting tools with export and print features

Advanced user management with secure access and event logging

Best Support and issue resolution process for minimum business downtime
How you can benefit?

Automatic and instant processing of data from almost all kinds of medical equipment.

No Human intervention thereby giving almost zero input errors

Multifold Increase in efficiency and productivity of your healthcare organization

Fastest turnaround of patient reports thereby directly adding to the business profits and growth

Teleradiology Services

CCSPL has a team of highly experienced Radiologists who have been working in the radiology domain for more than 10-15 years.

In general, radiology services are extremely crucial component of the medical practice. Analysis and diagnosis using the radiology reports is usually the showstopper, as clinicians/physicians don't have time to prepare the reports for the scans and test being performed. As a result, Patients usually have to wait for 2-3 weeks to receive the results of their tests.

To facilitate an electronic exchange of medical and patient information between hospitals, consultants and clinics, Picture Archiving and Communication Systems (PACS) can be used, which captures, stores, distributes and display static or moving images such as electronic X-Rays, ECG scans etc. These can be easily loaded onto a PACS compatible system and shared across several consulting locations.

But these images need to be accompanied by a medical report by a doctor from that specialty describing/explaining the scans to make the diagnosis faster and treatments safer. CCSPL can help hospitals significantly reduce this waiting period and offer a faster turn-around-time. We are also one of the few healthcare organizations offering Remote Image Processing and Teleradiology services where we receive X-Rays, MRI scans, CT scans etc from hospitals and our specialist doctors would closely study those scans and images, prepare a report and send it back to the hospital within 24 hours. This can significantly reduce the waiting period for getting the test results back, which currently stands between 5-10 working days.

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